Clinical lung cancer最新文献

{"title":"Prognostic Significance and Biomarker Identification by Progression Patterns in Patients With Small Cell Lung Cancer After Immune Checkpoint Inhibitors","authors":"Paresh Kumar ,&nbsp;James E. Slaven ,&nbsp;Tianhao Zhou ,&nbsp;Mya Tran ,&nbsp;Misty D. Shields","doi":"10.1016/j.cllc.2026.03.014","DOIUrl":"10.1016/j.cllc.2026.03.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Chemoimmunotherapy for small cell lung cancer (SCLC) is initially effective; however, relapse is common. Patterns of progression may serve to prognosticate outcomes and identify biomarkers for relapsed SCLC.</div></div><div><h3>Patients and Methods</h3><div>Electronic medical records of patients with SCLC who progressed after chemoimmunotherapy were reviewed. Response was classified into oligoprogression (OP, ≤ 5 progressive or new lesions in ≤ 2 organs) and non-oligoprogression (non-OP) for comparison of outcomes. Tissue biopsies at diagnosis and liquid biopsies at progression were evaluated.</div></div><div><h3>Results</h3><div>Females and patients with fewer <em>de novo</em> metastatic sites were more likely to have OP (<em>P</em> &lt; .05). OP associated with improved overall survival (17.5 vs. 8.6 months, <em>P</em> &lt; .001), survival after progression (11.1 vs. 2.3 months, <em>P</em> &lt; .001), and progression-free survival with subsequent therapy (4.6 vs. 1.8 months, <em>P</em> &lt; .01). Patients with non-OP were more likely to be hospitalized (29.8% vs. 66.7%, <em>P</em> &lt; .001), transition to hospice within three months (6.4% vs. 50%, <em>P</em> &lt; .001), and receive fewer subsequent therapies (89.4% vs. 58.3%, <em>P</em> = .01). Surprisingly, the chemotherapy-free interval (CTFI) was not significantly associated with post-progression overall survival (HR 1.62, 95% CI, 0.82-3.18; <em>P</em> = .16). Biomarker analysis identified hypermethylation at 8 CpGs annotating <em>HOXA5</em> (<em>P</em> &lt; .01), which correlates with non-OP and predicts inferior survival in an independent patient cohort (HR 0.44, <em>P</em> = .02)<em>.</em></div></div><div><h3>Conclusion</h3><div>PD patterns are an excellent tool to identify patients with relapsed SCLC who are at high risk of mortality, hospitalization, clinical decline, and poor outcomes with subsequent therapies. Such patients should be prioritized for clinical trial enrollment. Prospective validation for outcomes with chemoimmunotherapy by HOXA5 status is warranted.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 149-159.e7"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Prognostic Factors for Sex Differences in Lung Cancer Survival: A Retrospective Analysis of Real-World Data in Australia","authors":"Xue Qin Yu ,&nbsp;Michael David ,&nbsp;Preston Ngo ,&nbsp;Pavla Vaneckova ,&nbsp;Deme Karikios ,&nbsp;Mei Ling Yap ,&nbsp;Margaret Brand ,&nbsp;Jessie Zeng ,&nbsp;Sanuki Tissera ,&nbsp;John Zalcberg ,&nbsp;Marianne F. Weber ,&nbsp;Rob G. Stirling","doi":"10.1016/j.cllc.2026.03.001","DOIUrl":"10.1016/j.cllc.2026.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer survival rates are higher among women than men across many populations globally. We examined real-world data on prognostic factors for lung cancer in Australia and assessed their contribution to the sex survival disparity.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of data from the Victorian Lung Cancer Registry. People diagnosed with lung cancer during 2016 to 2022 were included with follow-up to August 2023. One-year overall survival was estimated by sex and stratified by 4 domain prognostic factors. The contribution of 4 domains of factors (patients’ characteristics, smoking history, tumor-related and treatment-related factors) to sex-based survival differences (alone and jointly) was assessed with multiple Cox proportional hazard regressions.</div></div><div><h3>Results</h3><div>A total of 5313 women and 6540 men were diagnosed with lung cancer, with median 1-year survival 76.5% and 69.4%, respectively. The unadjusted hazard of all-cause death was significantly higher for men than women 1-year post-diagnosis (HR = 1.38, 99% CI, 1.28-1.49, <em>P</em> &lt; .0001). The survival disparity remained statistically significant when each domain of prognostic factors was evaluated individually. Multivariable analysis revealed that treatment-related factors explained about 77% of the overall survival difference, followed by smoking history and tumor-related factors (explaining 26% and 24% respectively). After adjusting for all 4 domains of prognostic factors together, the excess risk of death among men was reduced by about 82% (HR = 1.05, 99% CI, 1.00-1.11, <em>P</em> = .02).</div></div><div><h3>Conclusion</h3><div>The sex-related lung cancer survival disparity in Australia is largely accounted for by treatment disparities, indicating an opportunity to explore sex differences in treatment preferences, options, and access.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 65-72.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicogenomic Predictors of First-line Immune Checkpoint Inhibitor Outcomes in Non–Small Cell Lung Cancer: A Nationwide CCAT Cohort From Japan","authors":"Mika Iwasaki ,&nbsp;Takahiro Ando ,&nbsp;Koki Fujii ,&nbsp;Kousuke Watanabe ,&nbsp;Katsutoshi Oda ,&nbsp;Hidenori Kage","doi":"10.1016/j.cllc.2026.03.003","DOIUrl":"10.1016/j.cllc.2026.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) varies, requiring predictive biomarkers.</div></div><div><h3>Methods</h3><div>We analyzed the nationwide Center for Cancer Genomics and Advanced Therapeutics (C<img>CAT) database and identified 1629 patients with stage IV NSCLC who received first-line ICI-based therapy between 2019 and 2025. The primary endpoint was time to treatment failure (TTF); the secondary endpoint was overall survival (OS). Age-stratified Cox models were adjusted for covariates. Genomic covariates included <em>KRAS, KEAP1</em>, and <em>STK11</em>, with genes from exploratory screening. We tested <em>KRAS</em>–<em>KEAP1</em> and <em>KRAS</em>–<em>STK11</em> interactions. Sensitivity analyses included an FFPE-only subset with tumor mutational burden (TMB) and models adjusting for the ECOG status.</div></div><div><h3>Results</h3><div><em>BRAF</em> mutation was independently associated with longer TTF (HR 0.77, 95% CI 0.59-1.00; <em>P</em> = .049), whereas <em>KRAS, KEAP1</em>, and <em>STK11</em> alone were not. A significant <em>KRAS</em>–<em>KEAP1</em> interaction was associated with shorter TTF (HR 1.89, 95% CI 1.06-3.36; <em>P</em> = .032). In a 4-level comparison versus wild-type, <em>KRAS</em>-only and <em>KEAP1</em>-only were not significant, whereas <em>KRAS</em>–<em>KEAP1</em> co-mutation was associated with higher risk of failure (HR 2.48, 95% CI 1.50-4.10; <em>P</em> &lt; .001). Results were consistent across sensitivity analyses. <em>KEAP1</em> and <em>STK11</em> were associated with worse OS, while <em>BRAF</em> showed no OS advantage.</div></div><div><h3>Conclusions</h3><div>In first-line ICI–treated stage IV NSCLC, <em>KRAS</em>–<em>KEAP1</em> co-mutation, not <em>KRAS</em> or <em>KEAP1</em> alone, identifies patients at high risk of early failure, whereas <em>BRAF</em> was associated with longer TTF. These findings highlight the importance of co-mutation profiling and warrant prospective validation with integrative models incorporating PD-L1 and TMB.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 81-90.e7"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Versus Conventional Radiotherapy in Medically Inoperable Stage I Non–Small Cell Lung Cancer: A Bayesian Reanalysis of the LUSTRE Randomized Trial","authors":"Yanchen Wang ,&nbsp;Elysia K. Donovan ,&nbsp;Mark N. Levine ,&nbsp;Timothy J. Whelan ,&nbsp;Anand Swaminath ,&nbsp;Sameer Parpia","doi":"10.1016/j.cllc.2026.03.008","DOIUrl":"10.1016/j.cllc.2026.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The results of the LUSTRE trial investigating stereotactic body radiotherapy in early-stage non–small cell lung cancer were inconclusive. A Bayesian analysis could potentially address this by integrating prior knowledge.</div></div><div><h3>Methods</h3><div>The LUSTRE trial was a randomized-controlled superiority trial conducted from 2014 to 2020. Patients with medically inoperable Stage I non–small cell lung cancer were randomized 2:1 to stereotactic radiotherapy (intervention) or conventional radiotherapy (control). The primary outcome was time-to-local control, defined as the period from randomization to absence of a primary tumor or marginal failure during follow-up. Primary analyses used Bayesian multivariable Cox regression, adjusting for strata (tumor size, tumor location, and clinical center). A neutral prior distribution was used for primary analysis, with optimistic (obtained from meta-analyses of 2 previous trials) and pessimistic prior distributions/knowledge for sensitivity analyses.</div></div><div><h3>Results</h3><div>Among 233 patients, 154 received stereotactic radiotherapy, and 79 received conventional radiotherapy. Using a noninformative neutral prior distribution, there was a 91% probability that the posterior adjusted hazard ratio (aHR) for local control with stereotactic radiotherapy was less than 1 (posterior aHR: 0.63, 95% credible interval, 0.32, 1.25). Incorporating the optimistic prior distribution, the posterior aHR was 0.62 (95% credible interval, 0.37, 1.02), indicating a 97% probability of benefit. Under the pessimistic prior distribution, the posterior aHR was 0.97 (95% credible interval, 0.71, 1.34), suggesting a 57% probability of benefit.</div></div><div><h3>Conclusions</h3><div>Post hoc Bayesian reanalyses provided additional insight into the posterior probability of local control benefit with stereotactic radiotherapy.</div></div><div><h3>LUSTRE trial registry ID</h3><div>NCT01968941 (date of registration: October 21, 2013)</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 117-122.e4"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Real-world Rebiopsy Events to Treatment Trajectories in EGFR/ALK/ROS1-Driven Non-small-cell Lung Cancer: Insights from the AURORA Cohort","authors":"C. Williams ,&nbsp;J. Rogers ,&nbsp;D. Arasaratnam ,&nbsp;T. Pham ,&nbsp;A. Nguyen ,&nbsp;L. Rashed ,&nbsp;F. Tadesse ,&nbsp;A. Truong ,&nbsp;H. Zhang ,&nbsp;L. Selbie ,&nbsp;J. Geng ,&nbsp;L. Tan ,&nbsp;S. Harden ,&nbsp;B.J Solomon ,&nbsp;M. Alexander","doi":"10.1016/j.cllc.2026.03.007","DOIUrl":"10.1016/j.cllc.2026.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Rebiopsy to identify resistance mechanisms and guide individualised treatment plans for systemic therapy is emerging as a fundamental practice in the management of oncogene-driven non-small cell lung cancer (NSCLC). The application of rebiopsy in real-world practice remains incompletely characterised.</div></div><div><h3>Patients and Methods</h3><div>This retrospective cohort study included patients with <em>EGFR</em>-, <em>ALK</em>-, and <em>ROS1</em>-positive NSCLC from the Australasian AURORA cohort treated at an Australian academic cancer centre (ACTRN12625000038493). Eligible adults were enrolled 2012–2025 with oncogenic driver status confirmed by fluorescence in situ hybridization (FISH) or next-generation sequencing (NGS). Data collected included biopsy timing, indication, and context, alongside systemic therapy, surgery, and radiotherapy. Progression re-biopsies were further characterised by molecular testing modalities, identification of acquired resistance mechanisms and evidence of histological transformation. Treatment trajectories were visualised using Swimmer plots to map biopsy and rebiopsy events across longitudinal lines of therapy, stratified by oncogenic driver.</div></div><div><h3>Results</h3><div>This analysis included 621 biopsies from 281 patients: 105 EGFR, 141 ALK, and 35 ROS1. All patients had a diagnostic biopsy (20% more than one); additional biopsies occurred at resection (20%), during treatment (11%), and during surveillance (2%). Among patients with disease progression, 56% underwent rebiopsy overall, with rates increasing over time from 51% before 2018 to 57% during 2018–2021 and 70% during 2022–2025 (<em>P</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>This real-world analysis provides contemporary insight into rebiopsy practices and longitudinal treatment patterns in oncogene-driven NSCLC. By mapping biopsy events to treatment trajectories, this study highlights evolving real-world practice, with rebiopsy rates at progression increasing over time across <em>EGFR, ALK</em>, and <em>ROS1</em> cohorts.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 108-116.e2"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood Socioeconomics and Lung Cancer Recurrence and Progression","authors":"Shelton Lo ,&nbsp;Yi Li ,&nbsp;Francine Laden ,&nbsp;William Kessler ,&nbsp;Michael Lanuti ,&nbsp;Justin F. Gainor ,&nbsp;Andrea Shafer ,&nbsp;David C. Christiani","doi":"10.1016/j.cllc.2026.03.011","DOIUrl":"10.1016/j.cllc.2026.03.011","url":null,"abstract":"<div><h3>Introduction/Background</h3><div>In the United States, about 50% of patients with lung cancer, across all stages, experience recurrence or progression even after undergoing successful treatment. Though research has been conducted on the risk of lung cancer recurrence and progression, the impact of neighborhood socioeconomic status has not been investigated.</div></div><div><h3>Materials and Methods</h3><div>We examined associations of neighborhood socioeconomic status (nSES) with lung cancer recurrence and progression among 3439 non–small cell lung cancer patients in the follow-up period from 1992 to 2012 in the Boston Lung Cancer Study. The nSES variables, including education level and annual household income, were estimated utilizing patient zip code and census tract data. Multivariable Cox regression was used to estimate associations.</div></div><div><h3>Results</h3><div>A total of 496 lung cancer recurrence and progression cases were observed in our study population. Patients living in zip codes where the majority of the population had fewer than four years of college education and an annual household income of less than $75,000 had a 2% and 10% increased hazard of lung cancer recurrence or progression, respectively; moreover, for every 10% increase in the neighborhood population that had less than 4 years of college education and had an annual household income of less than $75,000, patients had a 3% and 3% increased hazard of lung cancer recurrence or progression, respectively.</div></div><div><h3>Conclusions</h3><div>These findings suggest that nSES is associated with the risk of lung cancer recurrence and progression, with evidence of a potential exposure-response relationship. Disadvantaged neighborhoods may therefore represent a critical target for health policies and interventions aimed at reducing morbidity and mortality.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 132-140.e2"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Thoracic Radiotherapy in Metastatic NSCLC: A Retrospective Review in the Era of Immunotherapy and Targeted Therapies","authors":"Sina Mansoorian ,&nbsp;Janina Lehmann ,&nbsp;Lukas Käsmann ,&nbsp;Richard Gaus ,&nbsp;Cedric Richlitzki ,&nbsp;Helene Kravutske ,&nbsp;Florian Putz ,&nbsp;Nina-Sophie Schmidt-Hegemann ,&nbsp;Niels Reinmuth ,&nbsp;Amanda Tufman ,&nbsp;Julien Dinkel ,&nbsp;Gabriel Sheikh ,&nbsp;Claus Belka ,&nbsp;Chukwuka Eze","doi":"10.1016/j.cllc.2026.02.009","DOIUrl":"10.1016/j.cllc.2026.02.009","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer remains the leading cause of cancer-related deaths worldwide. Advances in immunotherapy and targeted therapies have improved survival in stage IV non–small cell lung cancer (NSCLC), highlighting the importance of local control of the primary tumor. Hypofractionated radiotherapy (hypo-RT), delivering high biologically effective doses (BEDs) over shorter durations, shows potential in locally advanced NSCLC but is underexplored in metastatic settings.</div></div><div><h3>Purpose</h3><div>This retrospective study evaluated 104 patients with stage IV NSCLC who received hypo-RT to the primary tumor at LMU Munich between December 2013 and June 2022. The primary endpoints were overall survival (OS) and progression-free survival (PFS), while the secondary endpoints included local failure-free survival, regional failure-free survival, distant failure-free survival, and the identification of prognostic factors.</div></div><div><h3>Findings</h3><div>Median OS and PFS were 15.4 months (95% confidence interval [CI]: 10.5-24.4) and 3.9 months (95% CI, 3.2-6.2), respectively. Significant predictors of OS included Eastern Cooperative Oncology Group performance status &gt;1 (hazard ratio [HR]: 3.260, <em>P</em> = .0003), male sex (HR: 1.869, <em>P</em> = .038), metastases in &gt;2 organ systems (HR: 2.014, <em>P</em> = .022), and BED &lt; 58.5 Gy (HR: 2.117, <em>P</em> = .017). Predictors of PFS included smoking history &lt;30 pack-years (HR: 1.912, <em>P</em> = .003) and BED &lt; 58.5 Gy (HR: 1.816, <em>P</em> = .025).</div></div><div><h3>Conclusion</h3><div>Hypo-RT is effective and feasible in metastatic NSCLC, with higher BEDs improving survival. Findings highlight the importance of personalized treatment strategies integrating clinical, molecular, and therapeutic factors.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 54-64.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147851403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Analysis of Different Histological Types of 2-3 cm pN0M0 Carcinoma Based on Surgical Procedure: A SEER Database Study","authors":"Zhongjie Wang ,&nbsp;Yuanyuan Xu ,&nbsp;Chao Chen ,&nbsp;Mingqiang Ye ,&nbsp;Shaojun Xu ,&nbsp;Shuchen Chen","doi":"10.1016/j.cllc.2026.02.006","DOIUrl":"10.1016/j.cllc.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Sublobar resection is increasingly used for 2-3 cm non-small cell lung cancer (NSCLC), but its survival benefit compared to lobectomy for intermediate- and high-risk histological types (acinar, papillary, micropapillary, and solid) remains unclear. This study compares oncological outcomes of 2 surgical procedures in node-negative, non-metastatic NSCLC patients with such histological types.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using data from the Surveillance, Epidemiology, and End Results database of the United States National Cancer Institute from 2004 to 2022. Patients with 2-3 cm pN0M0 histologically recorded as acinar, papillary, micropapillary, or solid carcinoma, who were treated with either sublobar resection or lobectomy, were included. We compared overall survival ​by histological type.</div></div><div><h3>Results</h3><div>Among 1,458 patients, univariate and multivariate analyses identified age, sex, surgical procedure, and pleural invasion as independent prognostic factors. Stratified analysis by histological type suggested that sublobar resection was associated with worse survival in patients with solid (<em>p</em> &lt; .001) and acinar carcinomas (<em>p</em> &lt; .001), while pleural invasion significantly affected overall survival only in acinar carcinoma (<em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>For patients with stage ​pN0M0​ non-small cell lung cancer measuring 2-3 cm, the specific histological type plays a critical role in guiding the choice of surgical extent and in evaluating the prognostic implications of pleural invasion. Individualized treatment based on histological type is essential to optimize outcomes.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 47-53.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Therapy After Pathologic Complete Response to Neoadjuvant Immunochemotherapy in Non–Small Cell Lung Cancer: A Multicenter Retrospective Real-World Study","authors":"Haoran Liu ,&nbsp;Zhitao Gu ,&nbsp;Keke Yu ,&nbsp;Ze-Rui Zhao ,&nbsp;Wanpu Yan ,&nbsp;Yifan Fang ,&nbsp;Xiangyang Yu ,&nbsp;Long Jiang ,&nbsp;Yiyang Wang","doi":"10.1016/j.cllc.2026.03.015","DOIUrl":"10.1016/j.cllc.2026.03.015","url":null,"abstract":"<div><h3>Background</h3><div>Whether resectable stage II to IIIB non–small cell lung cancer (NSCLC) patients could benefit from adjuvant therapy when pathologic complete response (pCR) is achieved after neoadjuvant immunochemotherapy remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective real-world study including patients with resectable stage II to IIIB NSCLC who achieved pCR after neoadjuvant immunochemotherapy and curative-intent resection between January 2020 and December 2023. Patients were categorized according to receipt of adjuvant systemic therapy or surveillance alone. Disease-free survival (DFS) was the primary outcome. Overall survival (OS), cancer-specific survival, recurrence patterns, and treatment-related adverse events (TRAE) were secondary outcomes. Propensity score matching and multivariable Cox regression were used for survival analyses.</div></div><div><h3>Results</h3><div>Among 214 eligible patients, 133 received adjuvant therapy and 81 underwent surveillance. During a median follow-up of 29.5 months, 25 patients experienced recurrence and 11 died. After propensity score matching, 148 patients (74 per group) were included. In the matched cohort, adjuvant therapy was not associated with improved DFS (pair-stratified hazard ratio [HR] 1.22, 95% confidence interval [CI] 0.51-2.95) or OS (pair-stratified HR 1.00, 95% CI 0.20-4.96) compared with surveillance alone. Recurrence after pCR was predominantly distant. Grade 3 or higher TRAEs were observed in 18% of patients who received adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>In patients achieving pCR after neoadjuvant immunochemotherapy, adjuvant systemic therapy was not associated with improved survival outcomes compared with surveillance alone and was accompanied by treatment-related toxicity. These findings suggest postoperative surveillance may be an appropriate consideration in discussions of postoperative management after confirmed pCR.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 160-169.e5"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of [18F]FDG PET/CT versus CT for NSCLC Surveillance: Secondary Analysis of a Randomized Clinical Trial","authors":"Kasper Foged Guldbrandsen ,&nbsp;Martin Bloch ,&nbsp;Kristin Skougaard ,&nbsp;Elisabeth Albrecht-Beste ,&nbsp;Hanne Marie Nellemann ,&nbsp;Martin Krakauer ,&nbsp;Peter Michael Gørtz ,&nbsp;Julie Marie Grüner ,&nbsp;Joan Fledelius ,&nbsp;Anne Lerberg Nielsen ,&nbsp;Paw Christian Holdgaard ,&nbsp;Søren Steen Nielsen ,&nbsp;Karin Hjorthaug ,&nbsp;Lise Barlebo Ahlborn ,&nbsp;Erik Jakobsen ,&nbsp;Anette Højsgaard ,&nbsp;Rene Horsleben Petersen ,&nbsp;Lars Borgbjerg Møller ,&nbsp;Morten Dahl ,&nbsp;Boe Sandahl Sorensen ,&nbsp;Susanne Oksbjerg Dalton","doi":"10.1016/j.cllc.2025.11.011","DOIUrl":"10.1016/j.cllc.2025.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Following curative treatment for non-small cell lung cancer (NSCLC), surveillance to detect recurrence is recommended. While computed tomography (CT) is the current standard for follow-up imaging, the optimal surveillance strategy remains debated. This study compares the diagnostic accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT; hereafter referred to as PET/CT) and CT for NSCLC surveillance.</div></div><div><h3>Materials and Methods</h3><div>This study represents a secondary analysis of data from a randomized controlled trial (SUPE_R, ClinicalTrials.gov NCT03740126) of patients with stage IA-IIIC NSCLC who completed curative-intent treatment between February 2019 and February 2022. CT and PET/CT scans were compared for recurrence detection using biopsy, multidisciplinary team assessment, or follow-up imaging as reference standards.</div></div><div><h3>Results</h3><div>The analysis included 899 PET/CT scans and 852 CT scans from 692 patients (mean age 69 years ± 8 [SD]; 412 female). For detecting recurrence, PET/CT demonstrated a higher sensitivity (88% [95% CI, 80%-93%] vs. 62% [95% CI, 50%-73%]; <em>P</em> &lt; .001) but lower specificity (89% [95% CI, 86%-91%] vs. 96% [95% CI, 94%-97%]; <em>P</em> &lt; .001) compared to CT. PET/CT demonstrated a higher sensitivity compared to CT after treatment with chemoradiotherapy (100% [95% CI, 72%-100%] vs. 46% [95% CI, 19%-75%]; <em>P</em> = .006) and at 0 to 6 month after treatment (83% [95% CI, 63%-94%] vs. 41% [95% CI, 21%-65%]; <em>P</em> = .008).</div></div><div><h3>Conclusion</h3><div>The higher sensitivity of PET/CT, particularly after chemoradiotherapy and early post-treatment, suggests it may be particularly valuable in these high-risk scenarios. However, CT remains preferred for routine surveillance of low-risk patients given its superior specificity.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 180-189.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}